FIELD OF THE INVENTION
[0001] The present invention relates generally to the field of catheters. More particularly,
the present invention relates to the field of catheter guidewires.
BACKGROUND OF THE INVENTION
[0002] Percutaneous angioplasty is a therapeutic medical procedure for increasing blood
flow through a blood vessel.
[0003] For one known procedure, a guide catheter is inserted into the cardiovascular system
of a patient and guided toward a region having accumulated deposits along the inner
walls of a blood vessel. An elongated flexible guidewire, such as disclosed in EP-A-0611073,
is inserted into the guide catheter and guided beyond the distal end of the guide
catheter through the cardiovascular system to the deposit region. As the path to the
deposit region may be tortuous, the guidewire is typically flexible and bent to a
desired configuration at a distal tip of the guidewire to facilitate steering of the
guidewire into branching blood vessels. The guidewire typically has radiopaque regions
viewable with an x-ray imaging system to monitor guidewire progress through the patient.
The disclosures of EP-A-0611073 form the basis for the preamble of claim 1 appended
hereto.
[0004] An elongated catheter having a deflated balloon is routed over the guidewire so as
to position the deflated balloon in the deposit region. Once positioned, the balloon
may be inflated to widen the passageway through the deposits in the blood vessel and
therefore increase blood flow.
SUMMARY OF THE INVENTION
[0005] One object of the present invention is to provide for a guidewire that may be pushed
through a subject with relative ease.
[0006] Another object of the present invention is to provide for a guidewire having a relatively
stiff proximal portion and a relatively flexible distal portion.
[0007] Another object of the present invention is to provide for a guidewire having a relatively
flexible corewire with a relatively stiff sleeve at a proximal portion of the corewire.
[0008] Another object of the present invention is to provide for a guidewire having a superelastic
corewire with a relatively stiff sleeve at a proximal portion of the corewire.
[0009] In accordance with the present invention, as defined in claim 1, a guidewire has
an elongated corewire formed from a first material and an elongated sleeve secured
to the corewire such that the sleeve surrounds at least a portion of a proximal segment
of the corewire. The sleeve is formed from a second material having a greater stiffness
than the first material. The first material may exhibit superelastic properties and
may include an alloy having nickel and titanium. The second material may include stainless
steel. The sleeve may be generally cylindrical in shape. The corewire includes at
least one segment that tapers toward a distal end of the corewire. A spring may be
secured to the corewire such that the spring surrounds a distal segment of the corewire.
The guidewire may be used in combination with a catheter.
[0010] Also in accordance with the present invention, as defined in claim 8, a method for
fabricating a guidewire includes steps of providing an elongated corewire formed from
a first material, providing an elongated sleeve formed from a second material having
a greater stiffness than the first material, surrounding at least a portion of a proximal
segment of the corewire with the sleeve, and securing the sleeve to the corewire to
fabricate the guidewire. The first material may exhibit superelastic properties and
may include an alloy having nickel and titanium. The second material may include stainless
steel. The sleeve may be generally cylindrical in shape. The corewire may be provided
with at least one segment that tapers toward a distal end of the corewire. A spring
may be secured to the corewire such that the spring surrounds a distal segment of
the corewire.
[0011] Other objects, features, and advantages of the present invention will be apparent
from the accompanying drawings and from the detailed description that follows below.
BRIEF DESCRIPTION OF THE DRAWINGS
[0012] The present invention is illustrated by way of example and not limitation in the
figures of the accompanying drawings, in which like references indicate similar elements
and in which:
Figure 1 illustrates a balloon catheter guided over a guidewire to a deposit region
of a blood vessel;
Figure 2 illustrates the catheter of Figure 1 when viewed with an imaging system;
and
Figure 3 illustrates the guidewire of Figure 1.
DETAILED DESCRIPTION
[0013] Figure 1 illustrates a distal portion of an elongated catheter 200 being guided over
an elongated guidewire 300 to a deposit region of a blood vessel 100 in the cardiovascular
system of a subject. The deposit region of blood vessel 100 includes deposits 120
that have accumulated along the inner walls of blood vessel 100, restricting blood
flow through blood vessel 100.
[0014] To guide catheter 200 to the deposit region, an elongated guide catheter is first
inserted into an entry point of the subject and through the cardiovascular system
of the subject toward the deposit region. A distal end 302 of guidewire 300 is inserted
into the guide catheter at the entry point of the subject and routed beyond the distal
end of the guide catheter through the cardiovascular system to the deposit region
of blood vessel 100.
[0015] Guidewire 300 includes an elongated corewire 320 and an elongated sleeve 340 surrounding
at least a portion of corewire 320, as illustrated in Figure 3. Corewire 320 and sleeve
340 may be formed from any suitable material to any suitable shape, width, and length
depending, for example, on the size of the blood vessels through which guidewire 300
is to be guided and on the location of the deposit region from the entry point of
the subject.
[0016] For one embodiment, as illustrated in Figure 3, corewire 320 includes a proximal
segment 322 having a substantially uniform diameter. Proximal segment 322 may have
any suitable diameter and any suitable length, such as one that spans over three-fourths
the overall length of corewire 320 for example. The remainder of corewire 320 tapers
toward a distal segment 330 at distal end 302 of guidewire 300. Corewire 320 tapers
from segment 322 along a segment 324 toward distal end 302 to a segment 326 having
a substantially uniform diameter. Corewire 320 further tapers from segment 326 along
a segment 328 to distal segment 330. Segments 324, 326, and 328 may be formed to any
suitable length and diameter using a suitable centerless grinding technique, for example.
[0017] Corewire 320 may have a total length in the range of approximately 1.78m (70 inches)
to approximately 3.05m (120 inches), for example. Segment 322 may have a length in
the range of approximately 1.35m (53 inches) to approximately 2.87m (113 inches),
for example, and may have a substantially uniform diameter in the range of approximately
0.18mm (0.007 inch) to approximately 0.38 (0.015 inch), for example. Segment 324 may
have a length in the range of approximately 25.4mm (1 inch) to approximately 76.2
mm (3 inches), for example. Segment 326 may have a length in the range of approximately
127mm (5 inches) to approximately 0.25m (10 inches), for example. Segment 328 may
have a length in the range of approximately 25.4mm (1 inch) to approximately 76.2
mm (3 inches), for example. Segments 324, 326, and 328 may taper toward distal end
302 to any suitable diameter.
[0018] Distal segment 330 is relatively flat and may be formed to any suitable dimensions
using any suitable technique, such as by rolling or stamping the distal tip of the
ground corewire 320. Distal segment 330 may have a width of approximately 127 µm (0.005
inch), for example, may have a length in the range of approximately 7.6 mm (0.3 inch)
to approximately 25.4 mm (1.0 inch), for example, and may have a thickness in the
range of approximately 25 µm (0.001 inch) to approximately 76 µm (0.003 inch), for
example.
[0019] A coiled wire spring 332 surrounds at least a portion of distal segment 330, as illustrated
in Figure 3. Spring 332 may also extend to surround at least a portion of segments
328, 326, 324, and/or 322 of corewire 320. The wire for spring 332 may have any suitable
diameter and may be wound with any suitable pitch between windings. Spring 332 may
be formed from any suitable material and may be secured to corewire 320 using any
suitable technique. Spring 332 may be formed from a radiopaque material, such as platinum
for example, and may be welded, brazed, or soldered to corewire 320. In welding, brazing,
or soldering spring 332 to distal segment 330, a relatively smooth, hemispherical
bead 334 may be formed at the tip of distal end 302, as illustrated in Figure 3.
[0020] Corewire 320 may be formed from a relatively flexible material having a suitable
lubricant coating or outer surface to facilitate the pushing and steering of corewire
320 through the cardiovascular system from the entry point of the subject. The tapering
of this flexible material toward distal end 302 also facilitates the steering of corewire
320 through the subject and, in particular, through a relatively tortuous path leading
to the deposit region of blood vessel 100.
[0021] The flexible material of corewire 320 further enables the bending and shaping of
distal segment 330 to a desired configuration. As torque is applied to a proximal
end 304 of guidewire 300 and transmitted to distal segment 330, the bent distal segment
330 may be oriented as desired to steer guidewire 330 in a suitable direction, such
as into branching blood vessels for example, as may be necessary to reach the deposit
region of blood vessel 100. Bead 334 helps to avoid damage to the inner walls of blood
vessels as a result of contact with the tip of distal end 302. As illustrated in Figure
2, an x-ray imaging system may be used to view radiopaque spring 332 and therefore
monitor the orientation of the bent distal segment 330 as well as the progress of
guidewire 300 as guidewire 300 is pushed and steered through the subject.
[0022] For one embodiment, corewire 320 may be formed from a suitable material exhibiting
superelastic or superelastic-like properties to provide enhanced flexibility and the
ability to bend distal segment 330 multiple times with minimized kinking. Corewire
320 may be formed from a suitable nickel-titanium (Ni
xTi
y) or Nitinol alloy, for example, and may be constructed in accordance with U.S. Patent
5,402,799 to Colon et al., entitled GUIDEWIRE HAVING FLEXIBLE FLOPPY TIP. For other
embodiments, corewire 320 may be formed from a plastic.
[0023] Sleeve 340 is configured to mate with corewire 320 in a coaxial manner so as to surround
at least a portion of corewire 320, as illustrated in Figure 3. Sleeve 340 may be
formed to any suitable size and shape depending, for example, on the size and shape
of corewire 320.
[0024] For one embodiment, as illustrated in Figure 3, sleeve 340 is a hypodermic tube or
hypotube that is generally cylindrical in shape and sized so as to snugly fit over
the outer surface of proximal segment 322 and surround at least a portion of proximal
segment 322. Sleeve 340 may have a length in the range of approximately 1.14 m (45
inches) to approximately 2.67 m (105 inches), for example, an inner diameter in the
range of approximately 0.2 mm (0.008 inch) to approximately 0.41 mm (0.016 inch),
for example, and a wall thickness in the range of approximately 25 µm (0.001 inch)
to approximately 127 µm (0.005 inch), for example.
[0025] Sleeve 340 is formed from a material that is stiffer than the flexible material for
corewire 320. One indication for stiffness, or resistance to elastic strain, may be
the modulus of elasticity for the materials used for corewire 320 and sleeve 340.
Sleeve 340 may be secured to corewire 320 using any suitable technique depending,
for example, on the materials for corewire 320 and sleeve 340. Sleeve 340 may be secured
to corewire 320 with an adhesive, for example, or may be welded, brazed, or soldered,
for example, to corewire 320.
[0026] With sleeve 340 secured to surround a proximal portion of corewire 320, guidewire
300 has a relatively stiff proximal portion to facilitate the pushing of guidewire
300 through the subject and also has a relatively flexible portion toward distal end
302 to facilitate not only the steering of guidewire 300 through the subject but also
the capability of guidewire 300 to reach the deposit region within a relatively tortuous
portion of the cardiovascular system of the subject. Sleeve 340 may have a suitable
lubricant coating or outer surface to facilitate the pushing of guidewire 300 through
the subject. Sleeve 340 may be treated with a Teflon spray, for example, to lubricate
the outer surface of sleeve 340.
[0027] For one embodiment with corewire 320 having superelastic or superelastic-like properties,
sleeve 340 may be formed from stainless steel, for example, to compensate for any
lack of stiffness of corewire 320 in pushing corewire 320 through the subject. Sleeve
340 may be formed from type 340 stainless steel, for example.
[0028] Although illustrated in Figure 3 for use with corewire 320, sleeve 340 may also be
used to provide for relatively stiff proximal portions of other corewires or guidewires,
such as those disclosed in U.S. Patent 5,402,799 and in U.S. Patent 5,267,574 to Viera
et al., entitled GUIDEWIRE WITH SPRING AND A HEAT SHRINKABLE CONNECTION.
[0029] To guide catheter 200 to the deposit region as illustrated in Figure 1, catheter
200 includes a center passageway having a diameter of suitable size to accommodate
guidewire 300. Guidewire 300 may be inserted into this center passageway at a distal
end 202 of catheter 200, and catheter 200 may be guided over guidewire 300 through
the guide catheter and beyond the distal end of the guide catheter to the deposit
region.
[0030] Near distal end 202, catheter 200 has a deflated balloon 220 and a radiopaque marker
band 226 positioned beneath balloon 220 as illustrated in Figure 1. Catheter 200 includes
another passageway extending from a proximal end of catheter 200 and along the length
of catheter 200 to balloon 220 for carrying fluid, for example, to inflate balloon
220. Once balloon 220 is positioned between deposits 120 of blood vessel 100, balloon
220 may be inflated to widen the passageway through deposits 120 and therefore increase
blood flow through blood vessel 100.
[0031] Guidewire 300 and catheter 200 may be positioned in the deposit region of blood vessel
100 by monitoring with an x-ray imaging system the progress of spring 332 and marker
band 226, respectively, as illustrated in Figure 2. For one technique, guidewire 300
is first pushed through the guide catheter and guided beyond the distal end of the
guide catheter to the deposit region. Catheter 200 is then pushed over guidewire 300
through the guide catheter and beyond the distal end of the guide catheter to the
deposit region. For another technique, guidewire 300 and catheter 200 are mated prior
to insertion into the guide catheter and together guided beyond the distal end of
the guide catheter to the deposit region by alternately advancing the guidewire 300
for a desired distance and pushing catheter 200 over the advanced portion of guidewire
300.
[0032] In the foregoing description, the invention has been described with reference to
specific exemplary embodiments thereof. It will, however, be evident that various
modifications and changes may be made thereto without departing from the scope of
the present invention as defined in the appended claims. The specification and drawings
are, accordingly, to be regarded in an illustrative rather than a restrictive sense.
1. A guidewire (300) comprising:
a) an elongated corewire (320), formed from a first material, having a proximal segment
(322) and at least one other segment (324) distal of the proximal segment (322) that
tapers towards a distal end of the core wire (320); and
b) an elongated sleeve (340) secured to the corewire (320);
characterised in that:
the sleeve (340) surrounds at least a portion of the proximal segment (322) of the
corewire (320), the sleeve (340) being formed from a second material having a greater
stiffness than the first material.
2. The guidewire (300) of claim 1, wherein the first material exhibits superelastic properties.
3. The guidewire (300) of claim 2, wherein the first material includes an alloy having
nickel and titanium.
4. The guidewire (300) of any one of claims 1 to 3, wherein the second material includes
stainless steel.
5. The guidewire (300) of any one of claims 1 to 4, wherein the sleeve (340) is generally
cylindrical in shape.
6. The guidewire (300) of any one of claims 1 to 5, including a spring (332) secured
to the corewire (320) such that the spring (332) surrounds a distal segment (330)
of the corewire (320).
7. The guidewire (300) of any one of claims 1 to 6, in combination with a catheter (200).
8. A method for fabricating a guidewire (300), comprising the steps of:
a) providing an elongated corewire (320) formed from a first material;
b) providing an elongated sleeve (340) formed from a second material having a greater
stiffhess than the first material;
c) surrounding at least a portion of a proximal segment (322) of the corewire (320)
with the sleeve (340); and
d) securing the sleeve (340) to the corewire (320) to fabricate the guidewire (300).
9. The method of claim 8 which is used to fabricate a guidewire (300) according to any
one of claims 2 to 6.
1. Führungsdraht (300) umfassend:
a) einen langgestreckten Kemdraht (320), geformt aus einem ersten Material mit einem
proximalen Segment (322) und mindestens einem weiteren Segment (324), das distal vom
proximalen Segment (322) gelegen ist, wobei letzteres zum distalen Ende des Kemdrahtes
(320) hin abgeschrägt ist und
b) eine am Kerndraht (320) befestigte langgestreckte Hülse (340);
dadurch gekennzeichnet, daß
die Hülse (340) zumindest einen Teil des proximalen Segmentes (322) des Kerndrahtes
(320) umschließt und aus einem zweiten Material geformt ist, welches eine größere
Steifigkeit hat als das erste Material.
2. Führungsdraht (300) nach Anspruch 1, bei welchen das erste Material superelastische
Eigenschaften hat.
3. Führungsdraht (300) nach Anspruch 2, bei welchen das erste Material eine Legierung
mit Nickel und Titan ist.
4. Führungsdraht (300) nach einem der Ansprüche 1 bis 3, bei welchen das zweite Material
rostfreier Stahl ist.
5. Führungsdraht (300) nach einem der Ansprüche 1 bis 4, bei welchen die Hülse (340)
eine allgemein zylindrische Form hat.
6. Führungsdraht (300) nach einem der Ansprüche 1 bis 5, welcher eine am Kemdraht (320)
befestigte Feder (332) aufweist, wobei diese Feder (332) ein distales Segment (330)
des Kerndrahtes (320) umgibt.
7. Führungsdraht (300) nach einem der Ansprüche 1 bis 6 in Kombination mit einem Katheter
(200).
8. Verfahren zur Herstellung eines Führungsdrahtes (300) mit folgenden Schritten:
a) Bereitstellen einees langgestreckten Kemdrahtes (320) geformt aus einem ersten
Material;
b) Bereitstellen einer langgestreckten Hülse (340) geformt aus einem zweiten Material
mit größerer Steifigkeit als derjenigen des ersten Materials ;
c) Umhüllen mindestens eines Teiles eines proximalen Segmentes (322) des Kemdrahtes
(320) mit der Hülse (340) und
d) Befestigen der Hülse (340) am Kemdraht (320) um den Führungsdraht (300) herzustellen.
9. Verfahren nach Anspruch 8 angewandt zur Herstellung eines Führungsdrahtes (300) nach
einem der Ansprüche 2 bis 6.
1. Fil de guidage (300) comprenant :
a) un fil d'âme allongé (320), formé à partir d'un premier matériau, ayant un segment
proximal (322) et au moins un autre segment (324), distal au segment proximal (322),
dont la section se réduit vers une extrémité distale du fil d'âme (320); et
b) un fourreau allongé (340) fixé au fil d'âme (320) ;
caractérisé en ce que :
le fourreau (340) entoure au moins une partie du segment proximal (322) du fil d'âme
(320), le fourreau (340) étant formé à partir d'un deuxième matériau ayant une rigidité
supérieure à celle du premier matériau.
2. Fil de guidage (300) selon la revendication 1, dans lequel le premier matériau présente
des propriétés d'élasticité importante.
3. Fil de guidage (300) selon la revendication 2, dans lequel le premier matériau comprend
un alliage comportant du nickel et du titane.
4. Fil de guidage (300) selon une quelconque des revendications 1 à 3, dans lequel le
deuxième matériau comprend de l'acier inoxydable.
5. Fil de guidage (300) selon une quelconque des revendications 1 à 4, dans lequel le
fourreau (340) a une forme généralement cylindrique.
6. Fil de guidage (300) selon une quelconque des revendications 1 à 5, comportant un
ressort (332) fixé au fil d'âme (320), de telle sorte que le ressort (332) entoure
un segment distal (330) du fil d'âme (320).
7. Fil de guidage (300) selon une quelconque des revendications 1 à 6, en combinaison
avec un cathéter (200).
8. Procédé de fabrication d'un fil de guidage (300), comprenant les étapes consistant
à :
a) prévoir un fil d'âme allongé (320), formé à partir d'un premier matériau ;
b) prévoir un fourreau allongé (340) formé à partir d'un deuxième matériau ayant une
rigidité supérieure à celle du premier matériau ;
c) entourer au moins une partie d'un segment proximal (322) du fil d'âme (320) avec
le fourreau (340); et
d) fixer le fourreau (340) au fil d'âme (320) afin de constituer le fil de guidage
(300).
9. Procédé selon la revendication 8, utilisé pour constituer un fil de guidage (300)
selon une quelconque des revendications 2 à 6.